It gets better if you do? Measuring quality care in Puerto Rico

Medical Anthropology: Cross Cultural Studies in Health and Illness

Volumn 29, Issue 3, 2010, Pages 303-329

  Mulligan, Jessica ^a  

^a The Holleran Center for Community Action and Public Policy   (United States)

Author keywords

Managed care; Medicare; Neoliberalism; Puerto rico; Quality

Indexed keywords

ARTICLE; HEALTH CARE QUALITY; HEALTH INSURANCE; HUMAN; METHODOLOGY; POLICY; PUERTO RICO;

HUMANS; MANAGED CARE PROGRAMS; POLICY; PUERTO RICO; QUALITY ASSURANCE, HEALTH CARE; QUALITY OF HEALTH CARE;

EID: 77955314509     PISSN: 01459740     EISSN: 15455882     Source Type: Journal    
DOI: 10.1080/01459740.2010.488663     Document Type: Article

References (63)

1. Acevedo-Vilá, A. 2005 Hearing on the Future of Medicaid. http://aspe.hhs.gov/medicaid/oct/Puerto_Rico_081705.pdf, accessed March 12, 2008.
2. Albizu-García, R. R., D. Juarbe, and M. Alegría 2004 Provider turnover in public sector managed mental health care. Journal of Behavioral Health Services & Research 31(3):255-265.
3. Alegría, M., T. McGuire, M. Vera, G. Canino, C. Albizu, H. Marín, and L. Matías 2001a Does managed mental health care reallocate resources to those with greater need for services? Journal of Behavioral Health Services & Research 28(4):439-455.
4. Alegría, M., T. McGuire, M. Vera, G. Canino, L. Matías, and J. Calderón 2001b Changes in access tomental health care among the poor and nonpoor: Results from the health care reform in Puerto Rico. American Journal of Public Health 91(9):1431-1434.
5. Alegría, M., T. McGuire, M. Vera, G. Canino, D. Freeman, L. Matías, C. Albizu, H. Marín, and J. Calderón 2001c The impact of managed care on the use of outpatient mental health and substance abuse services in Puerto Rico. Inquiry 38:381-395.
6. Arbona, G. and A. Ramírez de Arellano 1978 Regionalization of Health Services: The Puerto Rican Experience. Oxford: Oxford University Press.
7. Atkinson, S. 1993 Anthropology in research on the quality of health services. Cadernos de Saúde Pública, Rio de Janeiro 9(3):283-299.
8. Barry, A., T. Osborne, and N. Rose, eds. 1996 Foucault and Political Reason: Liberalism, Neo-liberalism and Rationalities of Government. Chicago: University of Chicago Press.
9. Boehm, D. 2005 The safety net of the safety net: How federally qualified health centers "subsidize" Medicaid managed care. Medical Anthropology Quarterly 19(1):47-63.
10. Burhans, L. 2007 What is quality? Do we agree, and does it matter? Journal for Healthcare Quality 29(1):39-44.
11. Centers for Medicare and Medicaid Services (CMS) 2008a Health plans, reports, files and data. http://www.cms.hhs.gov/HealthPlanRepFileData/02_SC.asp#TopOfPage, accessed January 15, 2008.
12. Centers for Medicare and Medicaid Services (CMS). 2008b Glossary. http://www.cms.hhs.gov/apps/glossary/default.asp?Letter=Q&Language=English, accessed March 7, 2008.
13. Clarke, J. 2004 Changing Welfare Changing States. London: Sage.
14. Colón Reyes, L. 2005 Pobreza en Puerto Rico. San Juan, Puerto Rico: Editorial Luna Nueva.
15. Comisión para Evaluar el Sistema de Salud del Estado Libre Asociado de Puerto Rico 2005 Informe Final. San Juan, Puerto Rico.
16. Commonwealth of Puerto Rico 1993 Ley 72. Salud y Sanidad Parte IX. Seguros de Salud 24 L.P.R.A.§7001. Aprobada el 7 de Septiembre de 1993.
17. Dalzell, M. D. 1998 Helping hands for HEDIS. Managed Care 7(6):34A-34H.
18. Delgado, J. A. 2005a Gobernadores apoyan pareo en fondos Medicaid. El Nuevo Día, June 17.
19. Delgado, J. A. 2005b Sin impacto el recorte de Medicaid. El Nuevo Día, October 25.
20. Donald, A. 2001 The Wal-Marting of American psychiatry. Culture, Medicine and Psychiatry 25: 427-439.
21. Duffy Burnett, C. and B. Marshall, eds. 2001 Foreign in a Domestic Sense: Puerto Rico, American Expansion, and the Constitution. Durham, NC: Duke University Press.
22. Ferguson, J. and A. Gupta 2002 Spatializing states: Toward an ethnography of neoliberal governmentality. American Ethnologist 29(4):981-1002.
23. Federal Register 2005 Medicare Modernization Act Final Rule. Federal Register 70(18):4587-4741.
24. Friedman, R. 2005 Islanders get small return on taxes for Medicare. San Juan Star, October 24.
25. Giri, A. 2000 Audited accountability and the imperative of responsibility. In Audit Cultures. M. Strathern, ed. Pp. 173-195. New York: Routledge.
26. Gordon, C. 1991 Governmental rationality: An introduction. In The Foucault Effect: Studies in Governmentality. G. Burchell, C. Gordon, and P. Miller, eds. Pp. 1-51. Chicago: University of Chicago Press.
27. Guarnaccia, P. J., M. Rivera, F. Franco, and C. Neighbors 1996 The experiences of ataques de nervios: Towards an anthropology of emotions in Puerto Rico. Culture, Medicine and Psychiatry 20:343-367.
28. Horton, S. 2006 The double burden on safety net providers: Placing health disparities in the context of the privatization of health care in the US. Social Science and Medicine 63(2006):2702-2714.
29. Horton, S. and L. Lamphere 2006 A call to an anthropology of health policy. Anthropology News, January:33, 36.
30. Horton, S., J. McCloskey, C. Todd, and M. Henriksen 2001 Transforming the safety net: Responses to Medicaid managed care in rural and urban New Mexico. American Anthropologist 103(3):733-746.
31. Jencks, S., E. D. Huff, and T. Cuerdon 2003 Change in the quality of care delivered to Medicare beneficiaries, 1998-1999 to 2000-2001. Journal of the American Medical Association 289(3):305-312.
32. Jencks, S., T. Cuerdon, D. Burwen, B. Fleming, P. Houck, A. Kussmaul, D. Nilasena, D. Ordin, and D. Arday 2000 Quality of medical care delivered to Medicare beneficiaries. Journal of the American Medical Association 284:1670-1676.
33. Kaiser Family Foundation 2008 MA Total Enrollment-Kaiser State Health Facts. http://www.statehealthfacts.org/comparetable.jsp?ind=327&cat=6, accessed January 15, 2008.
34. Kingfisher, C. and J. Maskovsky 2008 Introduction: The limits of neoliberalism. Critique of Anthropology 28(2):115-126.
35. Lambie, L. and S. Mattke 2004 Selecting Indicators for the Quality of Cardiac Care at the Health Systems Level in OECD Countries. http://www.oecd.org/dataoecd/28/35/33865450.pdf, accessed September 24, 2008.
36. Lamphere, L. 2005 Providers and staff respond to Medicaid managed care: The unintended consequences of reform in New Mexico. Medical Anthropology Quarterly 19(1):3-25.
37. López, L. 2005 De facto disentitlement in an information economy: Enrollment issues in Medicaid managed care. Medical Anthropology Quarterly 19(1):26-46.
38. Maskovsky, J. 2000 "Managing" the poor: Neoliberalism, Medicaid HMOs and the triumph of consumerism among the poor. Medical Anthropology 19:121-146.
39. McIntyre, D. 2001 Overview, history, and objectives of performance measurement. Health Care Financing Review, Spring.
40. National Committee for Quality Assurance (NCQA) 2006 NCQA an Overview. http://www.ncqa.org/Communications/Publications/overviewncqa.pdf, accessed November 1, 2006.
41. National Committee for Quality Assurance (NCQA). 2007 The State of Health Care Quality 2007. http:www.ncqa.org/tabid/136/Default.aspx, accessed July 1, 2008.
42. National Committee for Quality Assurance (NCQA). 2008a Report Cards. http://www.ncqa.org/tabid/60/Default.aspx, accessed September 10, 2008.
43. National Committee for Quality Assurance (NCQA). 2008b HEDIS Measure Development. http://www.ncqa.org/tabid/414/Default.aspx, accessed September 10, 2008.
44. Nelson, N. 2005 Ideologies of aid, practices of power: Lessons for Medicaid managed care. Medical Anthropology Quarterly 19(1):103-122.
45. O'Malley, P. 1996 Risk and responsibility. In Foucault and Political Reason. A. Barry, T. Osborne, and N. Rose, eds. Pp. 189-207. Chicago: University of Chicago Press.
46. Porter, T. 1995 Trust in Numbers: The Pursuit of Objectivity in Science and Public Life. Princeton: Princeton University Press.
47. Reinhold, S. 1994 Local conflict and ideological struggle: "Positive images" and Section 28. PhD dissertation, University of Sussex.
48. Rivera Ramos, E. 2001 The Legal Construction of Identity: The Judicial and Social Legacy of American Colonialism in Puerto Rico. Washington, DC: American Psychological Association.
49. Rose, N. 1996 Governing "advanced" liberal democracies. In Foucault and Political Reason: Liberalism, Neo-Liberalism and Rationalities of Government. A. Barry, T. Osborne, and N. Rose, eds. Pp. 37-64. Chicago: University of Chicago Press.
50. Rullán, J. 2004 Presentation at the Third Annual Symposium of the Healthcare Sector of Puerto Rico. San Juan, February 18, 2004.
51. Rylko-Bauer, B. and P. Farmer 2002 Managed care or managed inequality? A call for critiques of market-based medicine. Medical Anthropology Quarterly 16(4):476-502.
52. Shore, C. and S. Wright 1997 Anthropology of Policy: Critical Perspectives on Governance and Power. New York: Routledge.
53. Sotomayor, O. 2002 La probreza en Puerto Rico: Una guía para la política pú blica. In Ensayos Sobre la Pobreza en Puerto Rico. F. E. Martínez and F. A. Catalá, eds. Pp. 1-18. Hato Rey, Puerto Rico: Publicaciones Puertorriqueñas.
54. Stan, S. 2007 Transparency: Seeing, counting and experiencing the system. Anthropologica 49(2):257-273.
55. Strathern, M., ed. 2000 Audit Cultures: Anthropological Studies in Accountability, Ethics and the Academy. New York: Routledge.
56. Tendenciaspr.com 2008 Reforma de Salud: Personas Aseguradas y Elegibles. http://www.tendenciaspr.com/Salud/planes_medicos_reforma_salud.htm, accessed March 8, 2008.
57. US Census Bureau 2006 Puerto Rico Fact Sheet-American Community Survey Data Profile Highlights. http://factfinder.census.gov/servlet/ACSSAFFFacts?_event=Search&geo_id=&_geoContext=&_steet=&_county=&_cityTown=&_state=04000US72&_zip=&_lang=en&_sse=on&pctxt=fph&pgsl=010, accessed March 11, 2008.
58. US Census Bureau. 2008 Puerto Rico Fact Sheet. http://www.census.gov/census2000/states/pr.html, accessed January 15, 2008.
59. Wagner, W. G. 2005 Confronting utilization review in New Mexico's Medicaid mental health system: The critical role of "medical necessity". Medical Anthropology Quarterly 19(1):64-83.
60. Waitzkin, H., R. Williams, J. Bock, J. McCloskey, C. Willging, and W. Wagner 2002 Safety-net institutions buffer the impact of Medicaid managed care: A multi-method assessment in a rural state. American Journal of Public Health 92(4):598-610.
61. Wendland, C. L. 2007 The vanishing mother: Cesarean section and "evidence-based obstetrics." Medical Anthropology Quarterly 21(2):218-233.
62. Willging, C. E. 2005 Power, blame, and accountability: Medicaid managed care for mental health services in New Mexico. Medical Anthropology Quarterly 19(1):84-102.
63. Zarabozo, C. 2000 Milestones in Medicare managed care. Healthcare Financing Review 22(1):61-67.